Introduction to Allied Health Lessons 1-2

Healthcare Professional Roles and Patient Care Facilities:

Electronic Medical Records (EMR)

Electronic Medical Records (EMR) specialists and other healthcare professionals working with EMR manage and protect patients' personal health information and their facility's statistical data.

Job titles:

Electronic Medical Records (EMR) Specialists, Medical Records Technician, Health Information Technician or Specialist, and Healthcare Documentation Specialists.

There are four main types of data in a medical record:

• Administrative data includes demographic information about the patient, such as name, address, and date of birth.

• Clinical data is information such as office visits, admission dates, diagnosis, procedures, lab results, X-rays, and clinical notes.

• Financial data includes the patient's insurance and payment information.

• Legal data includes consent and release of information forms.

Roles Working with Medical Records Computer Systems

• most medical records are in digital or electronic format, some medical offices may still use paper records.

• will update database, manage data, and work with the Information Technology department of the organization.

Roles Working with Patients to Create Medical Records

Intake coordinators typically meet with patients before their healthcare service to create the foundation of the medical records.

Healthcare Professional Roles and Patient Care Facilities:

Medical biller and coders

translate the diagnoses, services, and supplies into medical coding sets for many reasons.

• include compliance with regulation and accreditation, reimbursement, and statistical reporting.

• may also work in using the coding to create, submit, and track medical claims.

• use a variety of systems and resources to send, track, reconcile, and collect insurance claims and other revenue sources.

• working in technology, finance, and medical records, among others.

Job titles:

Medical Biller, Medical Coder, Account Representative, Revenue Cycle Specialist, Claims Representative, and Denial Management Specialist.

Roles Focused on Health Insurance Claims Processing

Typically work as the liaison between the patient’s insurance and the healthcare facility.

Professionals in these roles must communicate clearly and consistently with insurance companies, the healthcare provider, and the patient.

Roles Focused on Financial Management of Accounts

work in the patient ledgers, which show the history of patient services, charges, applied payments and adjustments, and remaining balances.

Roles Focused on Managing Insurance Claims Processing and Accounting

These professionals must understand insurance, the billing systems, and healthcare accounting. They must be able to read and interpret a variety of reports related to the progress of the patient and insurance accounts.

Roles Working with Medical Records to Code for Reporting and Reimbursement

work in translating the medical record to appropriate code sets that will be used for compliance, quality reporting, statistical reporting, and reimbursement.

These professionals also submit inquiries to providers about accurate documentation of the medical record and quality of documentation. Understanding medical terminology and medical coding procedures and guidelines are crucial skills for these roles.

Medical Administrative Assistant

• often the link between the patients and the organization.

• facilitate the patient's access to care and assist the healthcare providers with administrative services.

• liaisons between the healthcare team members and those outside the organization.

• may also serve as coordinators for the healthcare team itself.

Roles Working in Outpatient Care Centers

Outpatient settings are places where patients receive their healthcare services and leave within the same day, such as a medical office, urgent care center, or ambulatory surgery center.

Their duties typically include:

• scheduling and setting patient appointments

• scheduling referrals to a specialist

• arranging patient admissions to hospitals

• setting up patient tests and procedures

• greet and receive, answer phones and emails

• update and file medical records and manage the organization's inventory

They must be proficient in computer skills and in other office equipment and technology.

Specific job titles include Front Office Coordinator, Authorization Specialist, Referrals Specialist, Medical Secretary, Front Desk Representative, and Administrative Assistant.

Roles Working in Inpatient Care Centers

Inpatient settings are places where people receive healthcare services over periods longer than one day.

The tasks in these roles are similar to those of the outpatient Medical Administrative Assistants; however, protocols may change with the different types of sites of care.

Specific job titles in the inpatient setting include Patient Registrar, Patient Intake Specialist or Coordinator, Unit Clerk, and Patient Navigator.

Medical Transcription

translate digitally recorded data, usually in audio format, into medical documents or written reports. They're often liaisons between the healthcare providers and the medical records team.

• may receive incoming lab orders and requisitions and enter relevant clinical data into the necessary software applications.

• may review and edit transcribed reports and dictated material for spelling, grammar, clarity, consistency, and proper medical terminology.

• also identify mistakes in reports and check with the provider to obtain the correct information.

Medical Transcriptionist:

They may work in different roles and have different functions:

• Transcriptionists typically work remotely, translating audio files to medicolegal (relating to both medicine and law) text or written documents.

• Document Specialists typically work in larger organizations. They translate a variety of media to documents or index documentation to import within the medical record.

• Medical Scribes work with healthcare providers to document healthcare services in real-time during the medical visit. They create medical records translating the healthcare provider and patient interaction into the permanent record. This requires an understanding of the EMR system, required patient information, medical terminology, and privacy and security measures.

Medical Assistant

healthcare professionals who work directly with patients and healthcare providers.

They may perform administrative and clinical duties.

A medical assistant’s main responsibility is to assist the healthcare provider in providing patient care.

This may include obtaining:

• vital signs

• collecting specimens

• administering medications

• drawing blood

• performing basic laboratory tests

• Medical assistants will also obtain a patient’s medical history and prepare patients for physical examinations and procedures.

• often work in outpatient settings and may work in different types of specialties.

Medical assistants often work in outpatient settings and may work in different types of specialties. Specific job titles include Certified or Registered Medical Assistant, Patient Care Technician, Medical or Care Associate, Clinical or Healthcare Assistant, and Medical Care Technician.

Using Communications Equipment

Phones, email, and fax are used in communication and business transactions.

Administrative professionals are often the "face" of the healthcare facility.

Information can be shared over the phone but is also often shared through fax or email. Some electronic health records software can share information digitally through the software.

Specific Job Titles:

Medical assistants often work in outpatient settings and may work in different types of specialties.

Certified or Registered Medical Assistant, Patient Care Technician, Medical or Care Associate, Clinical or Healthcare Assistant, and Medical Care Technician. The duties and titles may be based on specific tasks and work location.

When job searching:

Since specific job titles may vary and healthcare facilities may interchangeably use titles, it's helpful to focus on the knowledge and skills you have attained instead.

• use the job title as a guide and not necessarily a direct alignment to a particular position. Consider what skills and tasks you're trained to do. You may be surprised at how many skills you have and what knowledge you've attained that can translate to other job titles.

Other Healthcare Team Members:

Licenses and Certifications

Licensed:

Most licensed professionals complete a college degree before being eligible for their licenses. Licensing first requires demonstrating an occupation's standard of skill through an educational program.

Licenses are usually regulated by federal agencies or state boards of health and are required to be renewed regularly.

Certification:

Certification or registration is the acknowledgement or assurance that an individual has satisfied and completed the requirements to be competent in an activity or occupation. Although a few professions may require it, most certifications or registrations are voluntary or highly preferred by employers.

Doctors

There are several types of professionals or providers who hold the title of "doctor." Medical doctors, or physicians, hold a Medical Doctor (MD) degree or a Doctor of Osteopathic Medicine (DO) degree. Both are equally qualified to diagnose and treat patients.

Providers who hold a DO degree have training in Osteopathic Medicine, which is a more holistic approach to patient care and looks at how lifestyle and environment impact well-being.

Whether MD or DO degreed professionals, these doctors may choose a wide variety of specialties, such as pediatrics, cardiology, and surgery.

Other Healthcare Providers

nurse practitioners (NP) and physician assistants (PA)

sometimes called midlevel practitioners. These providers, similar to physicians, are licensed professionals and are able to work under a physician's supervision, depending on the state law.

Nurse practitioners (NP)

a registered nurse that completes a graduate education and training to become an advanced practice nurse (APRN). NPs have a wide scope of practice. They work in more advanced positions and roles, such as clinical nurse specialists, certified nurse practitioners, certified registered nurse anesthetists, and certified nurse-midwives.

Physician assistant (PA)

a provider who can diagnose illness, develop and manage treatment plans, prescribe medications, and often serve as a patient's primary healthcare provider. Their scope of practice varies according to jurisdiction and healthcare setting.

Other Licensed Healthcare Professionals

Practice Independently:

Physical Therapist

Occupational Therapist

Acupuncturist

Speech Therapist

Psychologist

Licensed Therapist

Midwife

Practice Under Supervision:

Registered Nurse (RN)

Licensed Practical Nurse (LPN)

EMT/Paramedic

Pharmacy Technician

Radiation Therapist

Dental Hygienist

Respiratory Therapist

Certified Professionals

may or may not have college degrees but have often completed a certificate or diploma training program.

Certification is granted by passing standardized testing given by an accredited testing agency. Certifications are often voluntary but may be preferred.

These healthcare team members are certified with specific skills that support the healthcare providers and help in the care of patients:

Certified Professionals:

Sonographer, Physical Therapy Technologist

Recreational Therapist, Laboratory Technologist

Documentation Analyst, Phlebotomist

Medical Auditor, EKG Technician

Medical Assistant, Telemetry Technician

Medical Biller, Tumor Registrar

Medical Coder, EMR,EHR Specialist

Radiation Technologist, CNA, Dental Assistant

Patient Care Technician, Surgical Assistant

Healthcare IT Specialist

Registered Health Information Technician

Outpatient Healthcare Facilities

provide services for patients in a single day. The services aren't for acute care and don't require the patient to stay longer than 24 hours.

Key Takeaways:

• Primary care facilities are located in a variety of locations and offer numerous services.

• Secondary care facilities provide services beyond primary care, offering specific care programs.

• Some healthcare providers offer in-home and mobile services.

Primary Care Facilities

provide primary care services such as screenings, preventive exams, and initial evaluations for care for patients across their whole life span:

• Primary Care Practices: Single provider or group practice offices that provide a variety of initial care services

• Local Community Screening Centers: These centers are typically within local government or municipal buildings. They offer screenings and some chronic care services.

• Urgent Care Centers: Storefront healthcare centers that offer extended hours and don't require appointments. They offer primary care with some ancillary services such as certain x-rays and some laboratory services.

• Family Planning Clinics: Specialized clinics that focus on reproductive healthcare such as birth control counseling and prescribing and testing for sexually transmitted infections (STIs).

Secondary Care Facilities

provide services beyond primary care.

Secondary care facilities are outpatient facilities that provide primary care as well as some surgical procedures or specialized care

There may be ancillary services provided in these organizations, such as laboratory or radiology services..

The following organizations typically provide a variety of services beyond primary care, such as some surgical procedures:

-Ambulatory surgery centers (ASC)

-Free-standing emergency departments

-Specialist physician practices

Other secondary care facilities may specialize in caring for patients with particular medical conditions and needs. These include:

-Cancer treatment centers

-Infusion centers

-Physical and occupational therapy practices

-Diagnostic imaging centers

-Free-standing laboratories

-Organ and blood banks

-Dialysis centers

-Reproductive health centers (in vitro fertilization)

-Outpatient mental health facilities

-Substance abuse outpatient facilities